How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.82 | Facility | None | $2.51 | $2.51 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $2.57 Typical High $3.39 | Professional | None | $2.40 | $2.57 | $3.39 |
BCBS Texas Setting Facility Modifier None Typical Low $2.04 Median $2.24 Typical High $2.51 | Facility | None | $2.04 | $2.24 | $2.51 |
BCBS Texas Setting Professional Modifier None Typical Low $1.86 Median $2.09 Typical High $2.09 | Professional | None | $1.86 | $2.09 | $2.09 |
Christus Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
Lucent Health Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $35.48 | Professional | None | $22.91 | $35.48 | $35.48 |
Moda Health Setting Facility Modifier None Typical Low $1.26 Median $2.57 Typical High $3.98 | Facility | None | $1.26 | $2.57 | $3.98 |
Moda Health Setting Professional Modifier None Typical Low $2.40 Median $2.57 Typical High $3.47 | Professional | None | $2.40 | $2.57 | $3.47 |
Molina Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $81.28 | Professional | None | $2.14 | $2.14 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.70 Median $2.57 Typical High $3.98 | Facility | None | $1.70 | $2.57 | $3.98 |
Providence Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $1.51 Median $2.04 Typical High $2.82 | Professional | None | $1.51 | $2.04 | $2.82 |
Wellpoint Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.39 Typical High $0.50 | Professional | 55 · Aftercare only | $0.36 | $0.39 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.26 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.24 | $0.26 | $0.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.39 Typical High $0.50 | Professional | 55 · Aftercare only | $0.36 | $0.39 | $0.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.26 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.24 | $0.26 | $0.32 |
Where Texas sits
The same service costs 2.5 times more in Hawaii than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 46th of 51
$2.19
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.